Coughing and can't stop
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Understanding Habit Cough: A Persistent Coughing Syndrome
Chronic Cough and Habit Cough Syndrome
Chronic Cough: Common Causes and Misdiagnosis
Chronic cough is a frequent symptom that leads many individuals, especially children and adolescents, to seek medical care. Typically, a cough is considered chronic if it persists for four or more weeks. While chronic cough is often attributed to conditions like asthma, it can also be functional in nature, meaning it occurs without an organic basis . This type of cough, known as habit cough (HC), is often misdiagnosed and treated as asthma, leading to unnecessary medical interventions and treatments.
Habit Cough: Characteristics and Diagnosis
Habit cough is characterized by a persistent, repetitive cough that can occur several times per minute and last for extended periods, ranging from several hours to all day. Notably, this cough completely disappears when the patient is asleep. The diagnosis of habit cough is primarily based on clinical history and observation, rather than extensive diagnostic tests. In a study involving 140 pediatric patients, the majority exhibited a loud barking cough, while a smaller percentage had a repetitive throat-clearing sound.
Treatment Approaches for Habit Cough
Ineffectiveness of Pharmacologic Treatments
Unlike asthma-related coughs, which can be managed with a short course of oral corticosteroids, habit cough does not respond to pharmacologic agents such as albuterol, inhaled corticosteroids, or antibiotics . This distinction is crucial for healthcare providers to recognize, as it can prevent unnecessary and ineffective treatments.
Behavioral Therapy: A Successful Intervention
The most effective treatment for habit cough is behavioral therapy, specifically suggestion therapy. In a clinical study, 95% of patients experienced complete cessation of their cough within 15 to 30 minutes of receiving suggestion therapy. This approach involves reassuring the patient and providing them with techniques to manage and stop the cough on their own. The sustained benefit of this therapy has been observed in multiple case series, highlighting its effectiveness in managing habit cough.
Conclusion
Habit cough is a functional disorder that is often misdiagnosed and treated as asthma, leading to unnecessary medical interventions. Recognizing the unique characteristics of habit cough, such as its persistence during wakefulness and absence during sleep, is essential for accurate diagnosis. Behavioral therapy, particularly suggestion therapy, has proven to be a highly effective treatment, offering rapid and sustained relief for patients. By distinguishing habit cough from other causes of chronic cough, healthcare providers can avoid extensive diagnostic procedures and ineffective pharmacologic treatments, ultimately improving patient outcomes.
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